confused resident

AAP announces a new screening tool for resident developmental delays

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confused resident

Oklahoma City, OK – American Academy of Pediatrics (AAP) has responded to a request from the American Medical Association (AMA) and constructed a new screening tool for recognition what the AMA designated as “residency developmental delay” (RDD). Per AMA, a new survey found that about 10% of residents, similar to pediatric patients, may suffer from RDD. Positive screening may necessitates referral to one of the Early Residential Intervention (ERI) centers.

Motor/fine motor development:

Age in life / residency Pediatric patient Resident
0-1 months Visual acuity of 20/400

Hands flexed and fisted

Can fixate on face at 8-15 inches

Visual diagnostic acuity of 1/400

Hands flexed when holding sign-out papers

Can distant self from upper level by 8-15 inches


2 months Can lift head when in prone position Can lift head from paper stack when presenting a patient
6 months Can sit with support


Can create assessment and plan with upper level’s support


12 months Can take few steps independently

Demonstrate object permanence

Can take few steps independently when called to evaluate a patient

Demonstrate disease permanence despite ongoing treatment

24 months Can climb up and down stairs

Runs well

Can climb up and down stairs without portable computer (WOW)

Runs well when a code is called

36 months Build a 3 block bridge

Uses a spoon effectively

Builds a 3-dagnosis assessment

Uses consults effectively


Language/Social development:

Age in life / residency Pediatric patient Resident
0-1 months Startles to sound


Startles to nurses’ sounds.



2 months Coos and laughs

Social smile


Coos when asked questions

Embarrassed smile


6 months Babbles with consonant sounds Babbles with consonant sounds when asked a question
12 months Says at least one word clearly Says at least one word clearly when speaking with a consult
24 months 2 word phrases

Speech is 50% intelligible

Identifies 6 body parts


714-word phrases when speaking with a consult

Speech is 5% intelligible to patient

Identifies 3 involved systems/organs

36 months Demonstrate a memory for pictures

Speaks with a 3-4 words sentences

Uses “what” and “who” questions

Speech is 75% intelligible

Demonstrate a memory for previous patients

Speaks with a 3-4 words sentences

Uses “what da” and “who cares” questions

Speech is 0% intelligible

Falls asleep during morning rounds, noon conferences and grand rounds


Red flags:

By end of first year Still differentiates between rales, rhonchi and crackles

Does not copy forward progress notes

Prefers home-made lunch over free conference lunch

Actually measures liver span


By end of first year:


Uses more than 50 words or more than 2 word phrases when writing progress note

Echolalia of consults’ assessment

Still prefers night shifts over calls

Still says “thanks for returning a page”


By middle of third year Still takes social history on every H&P

Does not inquire first about patient’s code status when responding to a code

Continues to introduce self when taking a consult


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